A 56-year-old immunocompromised woman undergoing chemotherapy for follicular lymphoma presented with refractory pneumonia. Despite standard antiviral treatment, her condition worsened, characterized by persistent SARS-CoV-2 detection via RT-PCR and progressive lung infiltrates. The diagnosis was persistent SARS-CoV-2 infection leading to severe pneumonia. She was successfully treated with an extended 25-day course of nirmatrelvir/ritonavir, leading to viral clearance and clinical improvement. This case highlights the efficacy of prolonged antiviral therapy in immunocompromised patients with persistent COVID-19 pneumonia, suggesting that extended treatment durations may be crucial for achieving viral eradication and clinical resolution in this vulnerable population.
Key note: Extended courses of nirmatrelvir/ritonavir can effectively treat persistent SARS-CoV-2 pneumonia in immunocompromised hosts.